Taking a look at the dark side of tourism in the Dominican Republic

In the Caribbean, the tourism industry is a major boost to the economy. Away from the stresses of everyday life, tourists lose their inhibitions and open their wallets, looking for an experience that truly takes them away. But FIU medical anthropologist Mark Padilla has found that what happens on the island is not staying on the island—and that has far-ranging consequences for the entire region.

Currently the Caribbean has the highest prevalence rates of HIV infection outside of sub-Saharan Africa. Nearly 75 percent of those cases occur in two countries: Haiti and the Dominican Republic, which comprise the island of Hispaniola. The Caribbean has also become a primary crossroad for cocaine and heroin from South America, a $5 billion a year trade that eventually makes its way to comprise the majority of the street level drugs in the United States and Europe.

At the same time, the Dominican Republic has also become the most popular tourist destination in the Caribbean, attracting more than six million visitors every year.

Padilla is embarking on a new, multiyear study, “Migration, Tourism, and the HIV/Drug-Use Syndemic in the Dominican Republic,” which aims to identify and address the different factors—such as sex, drugs and tourism– that are colliding and contributing to a major regional health crisis. “It’s wrong to look at one issue in isolation,” he noted. The high prevalence of HIV among sex workers and men who have sex with men in the Caribbean indicates that research, policies and prevention programs may be missing a key demographic.

“We are committed to reducing the impact of the dual epidemics of both HIV and drugs in the Caribbean in order to protect the health of both the Caribbean populations as well as Americans who are in close contact with the Caribbean,” Padilla said.

Padilla, associate professor of anthropology in FIU’s Department of Global and Sociocultural Studies, has spent more than a decade researching the men who migrate to tourist areas in the Dominican Republic looking for work. He has found that many of those men are at risk for acquiring HIV due to social isolation, the availability of drugs and the opportunity to make more money through sex work.

But this is the first comprehensive study that addresses all of the mitigating health and social issues as one problem—not five separate ones. “Our project would develop the first national intervention to reduce the impact of both HIV and drug abuse in Dominican tourism zones, and may serve as a model for the entire Caribbean region,” Padilla said.